Obstetrics and Gynecology Resident Well-Being: Findings From a National Survey.

Purpose: The aim of this study is to explore the well-being of obstetrics and gynecology (OB/GYN) residents and to determine whether patterns observed among trainees have persisted despite changes both within and outside of the clinical learning environment. Method: An observational cross-sectional study of residents in OB/GYN taking the 2022 national in-training examination was performed using an online survey. Respondents provided demographic information and self-assessment of burnout using a 2-item Maslach Burnout Inventory and resilience using a 2-item Connor-Davidson resilience scale as well as experience with depression, anxiety, and other mental health concerns. Residents were asked about the priority of physician well-being in their training program and whether they had thoughts of leaving the residency program. Kruskal-Wallis and chi-square tests explored differences in outcomes and associations between variables, including postgraduate year (PGY) and gender. Results: Of 5,761 residents taking the in-training exam, 3,741 (65%) participated and were included. Residents reported high rates of burnout (64.8%), depression (57.2%), and anxiety (70.9%). Suicidal ideation was reported among 147 (4%) residents. Average resilience scores (5.8) were lower than the general population. Women and nonbinary/nonconforming individuals fared worse than men in terms of burnout (66.9%; 65.3% vs 56.7%; P < .001), depression (58.5%; 61.2% vs 51.6%; P = .004), and anxiety (73.6%; 81.6% vs 59.3%; P < .001). Men demonstrated higher resilience scores (6.2) compared with women (5.9) and nonbinary/nonconforming (5.3) gender identities (P = .006). Thirty-four percent of nonbinary/nonconforming individuals had thoughts of leaving residency, compared to 21.5% of women and 21.8% of men residents (P = .008). Residents endorsing different racial identities did not have significantly different rates of burnout but did differ in other outcomes. Depression and anxiety also varied by race. Residents who identified as Black had notably increased likelihood of reporting depression (66%), considering leaving residency (33%), or endorsing suicidal ideation (8.6%) than other groups. Discussion: This national survey of OB/GYN residents demonstrates high rates of distress reported by trainees. While certainly reflecting the impact of the COVID-19 pandemic, there are concerning patterns about the role that gender, race, and residency program climate may play in the experience of residents. Women reported higher rates of burnout, depression, and anxiety, and nonbinary/nonconforming individuals reported higher rates of considering leaving residency training. The finding that burnout, depression, and anxiety were found in over three-quarter of residents who perceived wellness was not a priority in their training program is a resounding call to action. While the sources of these problems are multifactorial, training programs and hospital systems must support and message physician well-being as an urgent priority. Significance: OB/GYN residents’ personal background influences their reported well-being in residency, and program climate has a strong association with their experience. Despite powerful external forces driving distress in physicians, residency programs must make well-being a priority for the benefit of the trainees and their patients.